ACHC on CMS Final Rule: Annual DMEPOS Accreditation, Survey Readiness, and Ownership Changes

ACHC on CMS Final Rule: Annual DMEPOS Accreditation, Survey Readiness, and Ownership Changes

This week on the Claim to Fame podcast, Alex and Wayne interview ACHC's Kris Rivotti (clinical compliance educator for DMEPOS) and Deborah Panza (associate program director for DMEPOS, and sleep) about ACHC’s education-focused accreditation approach and recent CMS Final Rule changes. They explain that many suppliers will now be surveyed and reaccredited annually (with prior cycles honored if accredited before January 1), discuss survey readiness through updated policies, routine adherence to standards, mock surveys, and use of accreditor tools, and clarify location and corporate office survey requirements, including sampling rules for large chains (25–100 locations/year). They outline patient record review requirements (minimum five real patient files) and note surveys may be delayed if records aren’t available. They also cover change-of-ownership rules requiring new surveys/accreditation, possible new PTANs within 36 months, removal of temporary accreditation for new branches, common survey failures, and CMS’s fraud, waste, and abuse oversight intent.

Mathew Mammen on Fixing DME Decisioning with Ashvin AI’s Financial Operating System

On this episode Alex and Wayne interview Mathew Mammen of Ashwin AI, who shares his background as a software engineer, longtime DME owner, founder of a sleep diagnostics software platform, and leader at Prochant, and explains how DME “decisioning” from referral to cash is broken by portals, paperwork, faxes, conflicting orders, and repeated human adjudication that create rework and slow payment. He describes Ashwin AI as a decisioning layer aimed at near real-time, absolutely certain intake clearance by combining multiple steps into one and enabling workflow reconfiguration using gen AI, not just speeding up existing tasks. Mommen argues DMEs must modernize to avoid being left behind, advises adopting consumer-grade KPIs while meeting payer requirements, and says winners will stay humble, take risks, and “stay foolish.”

Bradley Smith on DME M&A: When to Sell, How to Grow via Acquisition, and What Drives Valuations

Alex and Wayne interview Brad Smith of Vertes, a healthcare M&A firm focused on DME/HME, to discuss the grow-vs-sell decision and current market dynamics. Brad shares his background building a Texas DME company, expanding from mobility into oxygen via acquisition, completing a private equity recap in 2004, pursuing a continuum-of-care acquisition strategy, and ultimately selling after Medicare competitive bidding in 2008; he then shifted into transaction work and co-founded Vertes. He describes how acquisitions can be faster and less risky than organic growth and stresses transaction nuances and buyer protections. Brad notes 2020–2022 were boom years with higher valuations, 2023–2024 saw declines, and 2025 feels normalized but uneven; smaller DME valuations are lower unless there’s scale or a niche. He advises sellers to avoid single-buyer situations, focus on cash flow and strong teams, and says private equity-backed platforms will keep gaining share.

How Mask Fit AR Uses Facial Scanning and AI to Improve CPAP Mask Fit and Compliance, with Wade West

In this episode for the Claim to Fame podcast, Alex and Wayne interview Wade West, Vice President of MaskFit AR, about the company’s facial scanning technology designed to help CPAP patients find the right mask and size the first time. West explains MaskFit AR’s origins (about 14 years in development), its mask recommendations based on facial anatomy plus clinical questions (pressure, sleep position, deviated septum), and key differentiators including global patents for privacy/security (no patient photos transmitted) and nostril scanning accuracy under 0.1 mm for nasal pillow sizing. He discusses how poor mask fit drives noncompliance (50–55% average compliance; many cite the mask), ROI from reducing costly refits, and a fast workflow via web link/QR code with optional patient mask selection and virtual try-on. The conversation covers adoption barriers, interoperability via open APIs, and a future “Amazon-like” remote, monitored CPAP journey.

Growth Without Adding Cost in DME: Lowering Cost to Serve, Focused Growth, and Proving Value

Alex and Wayne interview Wes Hopper of Why Success Happens about helping DME providers grow without adding costs. Hopper shares his 30-year background across distribution, manufacturing, and consulting and says leaders are overwhelmed by fires, regulatory change, and profitability pressures while trying to put patients first. He argues providers should focus on lowering cost—not just price—by managing cost drivers in product, place (logistics/workflows), and promotion (their story), using technology to reduce repeat trips and platform fragmentation, and by freeing cash tied up in stagnant inventory. He highlights coordination gaps between departments, the need for data-driven conversations with referral sources, and using manufacturer/distributor reps for ride-along selling. Hopper says most DMEs aren’t ready for value-based models because they lack a well-supported story and proof points, and he urges leaders to commit time weekly to think differently and use AI as a tool they control.